Behavioral Risk Factor Surveillance Survey

Transcription

1 Licking County Health Department Community Health Assessment Data Behavioral Risk Factor Surveillance Survey 28 A key strategic objective of the Licking County Health Department is to Monitor health status and understand health issues facing the community. Conducting periodic community health assessments allow us to better protect our residents form health problems and health hazards. This is achieved through the development of public health programs and plans and by communicating health information to empower people to make informed decisions about their health. Report Prepared by The Strategy Team 385 North High Street, Suite 22 Columbus, Ohio Orie V. Kristel, Ph.D., Principal Alison Pfent, M.A.

2 Table of Contents Overview... 1 Data Presentation... 2 Demographics of the 28 Licking County Survey... 3 Data Summary Risk Factors... 4 Data Summary Healthy Changes... 5 General Health Health Status... 6 Physical Health in Past 3 Days... 8 Mental Health in Past 3 Days... 1 Emotional Support, Life Satisfaction, Anxiety and Depression Health Impact in Past 3 Days Health Care Health Care Coverage Personal Health Care Providers Health Care Access Health Care Utilization Dental Health - Cleaning Dental Health - Tooth Loss Health Coverage - Eye Care Eye Care Cataracts, Glaucoma, and Macular Degeneration Visual Impairment Immunizations - Flu / Pneumonia Colon Cancer Screening Prostate Cancer Screening Pap Tests Hysterectomy Breast Cancer Screening Chronic Disease Asthma Diabetes Heart Attacks, Strokes, and Coronary Heart Disease... 5 Disability Disability Use of Special Equipment Health Behaviors Tobacco Use - Current Smokers Use of Other Tobacco Products Secondhand Smoke Alcohol Use... 61

3 Alcohol Use - Binge Drinking Exercise Overweight and Obesity Sleep HIV Testing Safety Belt Use Falls Miscellaneous Emergency Preparedness Health Care Workers Children Appendix Survey Methods... A-1 28 Survey Questionnaire... A-3

4 Licking County Health Department 28 BRFSS Page 1 Overview As part of its ongoing mission to inform and impact the public health of Licking County (Ohio) residents, the Licking County Health Department recently collected and analyzed data about the health status, quality of life, and risk factors of residents in the community. This was accomplished by the deployment of the Behavioral Risk Factor Surveillance Survey (BRFSS). Created by the Center for Disease Control and Prevention and used by the State of Ohio, the BRFSS was adapted for use in Licking County specifically, efforts were taken to ensure those health issues that were of most importance to public health professionals were included in the surveying. The BRFSS utilized a telephone survey to quantify the health needs and concerns of Licking County residents. Public health professionals will be able to use the data collected by this survey to answer the following conceptual questions: How healthy are Licking County residents? What does the health status of the Licking County community look like? Information regarding the survey methods used and the survey questions asked can be found in the Appendix, included under separate cover. Overall, 5 telephone interviews were conducted from February 28 through November 28. Data Presentation

5 Licking County Health Department 28 BRFSS Page 2 The data in this report are primarily reported via graphs. Because most of the questions asked were yes/ no questions, most graphs show the estimated population percentages of Licking County residents who report a particular health condition, risk factor, or behavior. Like any estimate produced from population surveys, the population parameter estimates are subject to various kinds of error. When possible, the graphs in this report display not only the estimated population percentages or averages but also error bars to indicate the precision of each estimate. These error bars illustrate the 95 confidence interval around each point estimate the range of values that most likely contains the true population parameter 95 of the time. Graphical use of error bars yields another benefit to the reader a visual test of statistical significance. Please see the example graph, below. Whenever one estimate s error bars overlaps with another estimate s error bars, those two estimates can be considered to be statistically similar. For example: The error bars for those aged 18-3 (28) overlap with those aged (26). Therefore, the difference in responses between these two groups is not statistically significant. 1 Example graph: Percentage of adults who report having lost at least one permanent tooth 85 However, if two or more estimates error bars do not overlap, the difference among the estimates is statistically significant. 1 For 4 28 example: 26 The error bars for those aged 18-3 (28) do not overlap with those aged (55) or with those aged 65 and over (85). Therefore, the difference between those aged 18-3 and those aged is statistically significant, as is the difference between those aged 18-3 and those aged 65 and over. The error bars for those aged 65 and over do not overlap with any other bars the responses from those aged 65 and over are statistically different from the responses from all other groups. When possible, data comparisons are made to Licking County s 26 BRFSS and Ohio s 27 BRFSS. The next two pages present a demographic overview of those who participated in the survey. Following this, a summary of critical risk factors and health issues provides a bird s eye view of the current health of Licking County residents. This summary allows readers to consider risk factor and health behavior data both in 27 and in comparison to historical data (i.e., to Licking County s 26 BRFSS and to Ohio s 27 BRFSS), which can help track healthy or unhealthy changes over time. 8 Licking and over 28 Survey Demographics Table 1: Licking County households (n=5) 1 Statistically significant differences refer to those differences that are unlikely to have been caused by random chance alone.

6 Licking County Health Department 28 BRFSS Page 3 Number in sample Unweighted Weighted 27 Census (ACS) Gender (n = 5) Male Female Age (n = 5) Ethnicity (n = 5) White Nonwhite Education (n = 5) Less than high school High school or GED Some college College graduate or more Income (n = 414) Less than $25, Between $25, and less than $5, Between $5, and less than $75, More than $75, Employment (n = 5) Employed Unemployed Other Marital status (n = 499) Married Divorced / Separated Widowed Single (never married) Note: Information about how the data were weighted can be found in the Appendix. ACS refers to the U.S. Census American Community Survey estimates for Licking County, Ohio. Data Summary Risk Factors This page summarizes the estimated prevalence of various risk factors and critical health issues reported by Licking County residents in 28. For each risk factor, the 28 weighted percentage is compared to 26 Licking County data and to 27 Ohio data and are presented as being significantly higher, lower, or similar (i.e., no statistical difference).

7 Licking County Health Department 28 BRFSS Page 4 Example: The percentage of Licking County adults reporting their general health status as fair or poor in 28 (18) is statistically similar to the Licking County 26 estimate (18) and the Ohio 27 estimate (16). Table 2: Data Summary Risk Factors and Critical Health Issues Risk Factors and Critical Health Issues (28 Licking County data) Weighted Percentage Compared to Licking County 26 BRFSS Compared to 27 Ohio BRFSS General health status is fair or poor 18 Similar (18) Similar (16) No health care coverage (Ages 18-64) 14 Higher (8) Similar (14) No access to health care when needed 13 Higher (9) Higher (9*) Medical visit in past 12 months 76 Higher (63) Similar (74*) Dental visit in past 12 months 7 Similar (7) Similar (73*) Flu shot during the past year (Ages 65+) 8 n/a Similar (73) Pneumonia vaccine ever (Ages 65+) 81 n/a Similar (7) Colonoscopy in past 2 years (Ages 5+) 59 Similar (59) Similar (57 $ ) PSA test in past 2 years (Ages 4+) 59 Similar (56) Similar (56 $ ) Pap test in past 3 years (Ages 18+) 76 Similar (8) Similar (83 $ ) Mammogram in past 2 years (Ages 4+) 77 n/a Similar (77 $ ) Diagnosed asthma 17 Similar (15) Similar (13) Diagnosed diabetes 12 Similar (11) Similar (1) Current smoking 27 Similar (21) Similar (23) Binge drinking 13 Similar (11) Lower (17) Overweight (BMI between 25. and 29.9) 4 n/a Similar (35) Obese (BMI greater than 3.) 29 n/a Similar (28) Adult always wears seatbelts 82 Similar (77) Similar (82 + ) $ = 26 OH BRFSS data, * = 1997 OH BRFSS data; + = 27 NHTSA data

8 Licking County Health Department 28 BRFSS Page 5 Data Summary Healthy Changes This page summarizes changes in critical risk factors and health behaviors over time, reviewing areas in which there have been healthy, unhealthy, and no changes. So the Licking County Health Department can assess the areas where county residents are making progress and where more progress may be needed, health objectives as determined by the 21 Healthy People initiative 2 are included as a reference when possible. Overall, what are the healthy changes reported by Licking County residents from 26 to 28? By healthy changes we refer to risk factors that decreased or proactive health behaviors that increased over time. Table 3-a: Healthy changes over past two years Risk Factors and Health Behaviors 28 BRFSS 21 Healthy People goal Medical visit in past 12 months 76 n/a Table 3-b reviews unhealthy changes, defined as risk factors that increased or proactive health behaviors that decreased over time. Table 3-b: Unhealthy changes over past two years Risk Factors and Health Behaviors 28 BRFSS 21 Healthy People goal No health care coverage (Ages 18-64) 14 No access to health care when needed 13 7 What about those risk factors or health behaviors for which there have there been no changes or unhealthy changes from 26 to 28? Table 3-c: No changes or unhealthy changes over past two years Risk Factors and Health Behaviors 28 BRFSS 21 Healthy People goal Dental visit in past 12 months 7 56 (MET) Current smoking Binge drinking 13 6 Overweight (BMI between 25. and 29.9) 4 n/a Obese (BMI greater than 3.) Pap test in past 3 years (Ages 18+) 76 9 Mammogram in past 2 years (Ages 4+) 77 7 (MET) PSA test in past 2 years (Ages 4+) 59 n/a Ever had a colonoscopy (5+) 59 5 (MET) Adult always wears seatbelts 82 n/a 2 See for more details.

9 Licking County Health Department 28 BRFSS Page 6 Health Status Assessing the community s overall health status provides the big picture context in which public health programs and initiatives must operate. In general, then, how do Licking County residents rate their overall health and well-being? A slight majority (51.7) of Licking County residents reported their health is excellent or very good while a minority (18.1) reported their health is fair or poor. Would you say that in general your health is excellent, very good, good, fair, or poor? (n=5) In 28, Licking County residents selfratings of overall health were positive a minority (18.1) said their health was fair or poor, 3.2 said their health was good, and a majority (51.7) said their health was excellent or very good. These patterns are similar to 26 Licking County data and to the most recent Ohio data Percentage of adults reporting health as Excellent, Very Good, or Good Licking 28 Licking 26 Ohio 27 Males and females reported similar ratings of health and well-being no statistically significant differences were noted on this factor Licking 28 Males Females All age groups reported similar ratings of health and well-being no statistically significant differences were noted on this factor Licking and over

10 Licking County Health Department 28 BRFSS Page 7 Additional Subgroup Differences: Ethnicity: No significant differences were noted between whites and non-whites on overall health status. Education: Those with lower education (high school grad or equivalent) were less likely to report their health was good or better (74.6). Those with higher education (college degree) were more likely to report their health was good or better (9.7). Employment: Those who were unemployed or who had an other employment status were less likely to report their health was good or better (6 and 7.1, respectively). o Note: Other employment status includes students, homemakers, and retired adults. o Note: Because the number of unemployed participants is low (under 25), these statistics should be interpreted cautiously. Those who were employed were more likely to report their health was good or better (92.6). Household income: As levels of household income increase, the percentage of those reporting good or better health also increases: o 62.3 of those with household incomes less than $25, reported good or better health. o 83 of those with household incomes between $25, and $5, reported good or better health. o 95 of those with household incomes over $75, reported good or better health.

11 Average # of days Avg # of days Licking County Health Department 28 BRFSS Page 8 Physical Health in Past 3 Days Focusing on the physical health of Licking County residents over the 3 days prior to surveying, how many days did they report their health was not good? Knowing this information adds to our understanding of the quality of life experienced by county residents. In 28, most Licking County residents reported good physical health. In the 3 days preceding the survey, a majority (59.7) said they had days in which their physical health was not good and 21.7 said they had 5 days or fewer in which their physical health was not good. However, 12.4 reported having 2 days or more in which their physical health was not good. Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 3 days was your physical health not good? (n=495) On average, males and females reported a similar number of poor physical health days in the 3 days preceding the survey. No statistically significant differences were noted Average number of days in which physical health was not good Licking 28 Male Female 4.3 Older respondents (65+) reported significantly more days of poor physical health as compared to 18-3 year olds and year olds Licking and over

12 Licking County Health Department 28 BRFSS Page 9 Additional Subgroup Differences: Ethnicity: Education: Those with high school degrees or equivalent reported more days in which their physical health was not good (6.). Those with college degrees reported fewer days in which their physical health was not good (2.4). Employment: Those whose employment status was classified as other reported more days in which their physical health was not good as compared to those who were employed (average days were 4.2 and 1.9, respectively), a statistically significant difference. Household income: As household income decreases, the average number of days in which one s physical health was not good increases significantly: o Income of great than $75, = average number of days was 1.7. o Income of $5, under $75, = average number of days was 3.2. o Income of $25, under $5, = average number of days was 5.1. o Income of less than $25, = average number of days was 7.9.

13 Average # of days Avg # of days Licking County Health Department 28 BRFSS Page 1 Mental Health in Past 3 Days Focusing on the mental health of Licking County residents over the past 3 days, how many days did they report their mental health was not good? In 28, most Licking County residents report good mental health. In the 3 days preceding the survey, a majority (65.3) said they had days in which their mental health was not good and 17.3 said they had 5 days or fewer in which their mental health was not good. However, 9.5 reported having 2 days or more in which their mental health was not good. Now thinking about your mental health, which includes stress, depression, and problems with emotions, for how many days during the past 3 days was your mental health not good? (n=498) On average, males and females reported a similar number of poor mental health days in the 3 days preceding the survey. No statistically significant differences were noted Average number of days in which mental health was not good Licking 28 Male Female All age groups reported a similar amount of poor mental health days in the 3 days preceding the survey. No statistically significant differences were noted Licking and over

14 Licking County Health Department 28 BRFSS Page 11 Additional Subgroup Differences: Ethnicity: Education: Those with less than high school education reported more days in which their mental health was not good (9.). Those with some college or college degrees reported fewer days in which their mental health was not good (average days were 2.7 and 3.4, respectively). Employment: Those who were unemployed reported more days in which their mental health was not good as compared to those who were employed (average days were 5.7 and 3, respectively), a statistically significant difference. Household income: Those with household incomes below $25, reported more days in which their mental health was not good (7.11). Those with higher household incomes (between $5, to $75, and $75, or above) reported fewer days in which their mental health was not good (average days were 1.78 and 2.81, respectively).

15 Licking County Health Department 28 BRFSS Page 12 Emotional Support, Life Satisfaction, Anxiety and Depression Two additional sets of questions in Licking County s 28 BRFSS probed issues of emotional / mental health in greater detail. Responses to the first set of questions, focusing on emotional support and overall life satisfaction, are shown below. How often do you get the social and emotional support you need? (n=491) In 28, 51 of Licking County residents reported they always get the social and emotional support they need, while 24 reported they usually get this support. When one compares 28 data to 26 data, one can observe a statistically significant trend of more social and emotional support, as evidenced by more residents reporting always and fewer residents reporting usually Percentage of Licking County adults who always or usually receive social/emotional support "Always" "Usually" "Always" "Usually" Licking 28 Licking 26 In general, how satisfied are you with your life? (n=498) Residents could respond to this question by saying they were very satisfied, satisfied, dissatisfied, or "very dissatisfied. When one combines responses of very satisfied and satisfied, one can see there was no statistically significant difference from 26 to 28 survey respondents report a similarly high satisfaction levels with their lives Percentage of Licking County adults who are very satisfied or satisfied with their lives Licking 28 Licking 26 In addition to providing responses about their overall mental health and a variety of emotional states, the 28 Licking County BRFSS posed an additional series of questions focusing on the number of days in which survey respondents experienced symptoms of depression. A table showing these questions, along with the most frequent responses to the questions, is shown on the next page. Overall, almost a fifth of the Licking County respondents interviewed reported being diagnosed as having an anxiety or depressive disorder.

16 Licking County Health Department 28 BRFSS Page 13 Indeed, 19 of those interviewed reported feeling bad about themselves, that they were a failure, or had let themselves or their families down at least once in the two weeks prior to participating in the survey. LICKING COUNTY HOUSEHOLDS Over the last 2 weeks, how many days have you had little interest or pleasure in doing things? (n=488) Over the last 2 weeks, how many days have you felt down, depressed or hopeless? (n=497) Over the last 2 weeks, how many days have you had trouble falling asleep or staying asleep or sleeping too much? (n=493) Over the last 2 weeks, how many days have you felt tired or had little energy? (n=499) Over the last 2 weeks, how many days have you had a poor appetite or eaten too much? (n=498) Over the last 2 weeks, how many days have you felt bad about yourself or that you were a failure or had let yourself or your family down? (n=493) Over the last 2 weeks, how many days have you had trouble concentrating on things, such as reading the newspaper or watching the TV? (n=497) Over the last 2 weeks, how many days have you moved or spoken so slowly that other people could have noticed? Or the opposite being so fidgety or restless that you were moving around a lot more than usual? (n=492) Average response (days) reporting at least 1 day LICKING COUNTY HOUSEHOLDS Has a doctor or other healthcare provider EVER told you that you had an anxiety disorder (including acute stress disorder, anxiety, generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, phobia, posttraumatic stress disorder, or social anxiety disorder)? (n=497) Has a doctor or other healthcare provider EVER told you that you have a depressive disorder (including depression, major depression, dysthymia, or minor depression)? (n=498) reporting yes 16 19

17 Average # of days Avg # of days Licking County Health Department 28 BRFSS Page 14 Health Impact in Past 3 Days To better understand how poor physical or mental health impacts daily lives of Licking County residents, survey respondents were asked to report the number of times poor health prevented them from engaging in usual activities. Fortunately, most Licking County residents daily lives are not negatively impacted by their health, according to those interviewed. In the 3 days preceding the survey, a majority (59.7) said they had days in which their health prevented them from engaging in usual activities and 16 said they had 5 days or fewer days. However, 1.3 reported that their health prevented them from engaging in usual activities in all of the previous 3 days. During the past 3 days, for about how many days did poor physical or mental health keep you from doing your usual activities, such as self-care, work, or recreation? (n=498) On average, males and females reported a similar number days negatively impacted by physcial or mental health. No statistically significant differences were noted Average number of days in which health prevented usual activities Licking 28 Male Female 5.1 All age groups reported a similar number of days negatively impacted by physical or mental health. No statistically significant differences were noted Licking and over

18 Licking County Health Department 28 BRFSS Page 18 Additional Subgroup Differences: Ethnicity: Non-whites reported significantly more days in which poor physical or mental health kept them from doing usual activities compared to whites (11.8 and 4.7 days, respectively). Education: Employment: Those who were employed reported the fewest days in which poor physical or mental health kept them from doing usual activities (1.59). Those who were unemployed and had an other employment status reported significantly more days in which health kept them from doing usual activities (both groups reported an average of 8.8 days). Household income: Those with household incomes greater than $75, reported the fewest days in which their physical or mental health kept them from doing usual activities (1.9). Those with lower household incomes reported more days in which their health kept them from usual activities: o Those with household incomes between $5, and $75, reported 3.6 days. o Those with household incomes between $25, and $5, reported 4.1 days. o Those with household incomes less than $25, reported 8.4 days. ADDITIONAL FINDINGS REGARDING PHYSICAL / MENTAL HEALTH In addition to providing overall judgments regarding their physical / mental health, Licking County s 28 BRFSS posed an additional series of questions focusing on the number of days in which specific emotional states were experienced. A table showing these questions, along with the average responses to the questions, is shown below. LICKING COUNTY HOUSEHOLDS During the past 3 days, for about how many days did pain make it hard for you to do your usual activities, such as self-care, work, or recreation? (n=498) During the past 3 days, for about how many days have you felt sad, blue, or depressed? (n=496) During the past 3 days, for about how many days have you felt worried, tense, or anxious? (n=495) During the past 3 days, for about how many days have you felt very healthy and full of energy? (n=499) Average response (days) reporting at least 1 day

19 Licking County Health Department 28 BRFSS Page 19 Health Care Coverage The ability to obtain medical care, whether it be preventative or for treatment of an illness or disease, has obvious links to overall levels of health and wellness. Residents without health care coverage may be less likely to seek medical care and therefore, may place their health at risk. What percentage of adults aged in Licking County lack health care coverage? As Medicare covers most adults aged 65 and over, they were excluded from this analysis. Do you have any kind of health care coverage, including health insurance, prepaid plans such as HMOs, or government plans such as Medicare? (n=45) In 28, 13.8 of Licking residents aged reported not having some form of health care coverage. This is significantly higher than the percentage reported in 26, but similar to the statewide average. In 27, 14 of Ohioans said they did not have access to health care coverage Percentage of adults without health care coverage Licking 28 Licking 26 Ohio 27 There were no significant differences in rates of health coverage between males and females Licking 28 Males Females There were no significant differences in rates of health care coverage between age categories. As expected, older respondents (those aged 65 and up) were the most likely to report some health care coverage only 3.8 of respondents in this age group reported they lacked health care coverage Licking

20 Licking County Health Department 28 BRFSS Page 2 Additional Subgroup Differences: Ethnicity: Education: Those with a high school degree were more likely to report lacking health care coverage as compared to those with a college degree (18.9 and 6.9, respectively). Employment: Unemployed respondents were more likely to report lacking health care coverage (44.7). Employed respondents and respondents who had an other employment status were less likely to report lacking health care coverage (1.6 and 15, respectively). Household income: Those with lower household incomes (less than $25,) were most likely to report lacking health care coverage (34.8). o 12.4 of those with incomes between $25,-$5, reported lacking health care coverage. o 4. of those with incomes between $5,-$75, reported lacking health care coverage. o 4.6 of those with incomes over $75, reported lacking health care coverage.

21 Licking County Health Department 28 BRFSS Page 21 Personal Health Care Providers How many Licking County residents have personal doctors or health care providers they see on a regular basis? Are some residents more likely than others to see a personal doctor, to have a medical home? Do you have one person you think of as your personal doctor or health care provider? (n=5) Is there more than one, or is there no person who you think of as your personal doctor or health care provider? (n=55) Percentage of adults who have at least one personal doctor In 28, 9.8 of Licking County residents reported having at least one personal doctor or health care provider. This is statistically similar to the proportion from 26 (91.2). The percentage of Licking County residents that report having more than one personal doctor in 28 (1.6) has decreased significantly since 26 (5.4). Because the number reporting more than one doctor is so small, it will be combined with the number reporting one doctor for the remaining analyses. No significant differences were noted between males and females doctor More than 1 doctor Licking 28 Licking Licking 28 Males Females A larger proportion of older respondents (those 45 and above) reported having at least one personal doctor compared to younger respondents (those 44 and younger) Licking and over

22 Licking County Health Department 28 BRFSS Page 22 Additional Subgroup Differences: Ethnicity: Education: Employment: Household income:

23 Licking County Health Department 28 BRFSS Page 23 Health Care Access Those who are unable to receive prompt medical care can experience medical conditions that become progressively more serious and complex over time. To what extent are Licking County residents able to get the medical care they need? Do some residents have more difficulty getting access to health care than others? Was there a time in the past 12 months when you needed to see a doctor, or other health care provider, but could not because of the cost? (n=5) In 28, 12.8 of Licking County residents reported a time in the past 12 months when they needed medical care but could not get it because of cost. This is higher than the percentage reported in 26 (8.8) and the statewide figure (9) in the last year for which state data were available (1997) Percentage of adults who could not access health care when needed because of cost Licking 28 Licking 26 Ohio 1997 No significant differences were noted between males and females Licking 28 Males Females No significant differences were noted among age groups Licking and over

24 Licking County Health Department 28 BRFSS Page 24 Additional Subgroup Differences: Ethnicity: Non-white respondents were more likely to report needing health care in the past 12 months but not getting it because of cost than were white respondents (35.4 and 1.9, respectively). Education: Employment: Household income: Those with higher incomes were significantly less likely to report barriers to accessing medical care: o 3.9 with household incomes greater than $75, reported needing health care in the past 12 months but not getting it. o 17.3 of those with incomes between $25, and $5, reported needing health care in the past 12 months but not getting it. o 17.9 of those with incomes less than $25, reported needing health care in the past 12 months but not getting it.

25 Licking County Health Department 28 BRFSS Page 25 Health Care Utilization One important component of health care, especially preventative health care, is an annual checkup. This includes both medical and dental checkups. To obtain a high-level measure of preventative health care practices among Licking County residents, two questions were asked: About how long has it been since you last visited a doctor for a routine checkup? A routine checkup is a general physical exam, not an exam for a specific injury, illness or condition. (n=495) How long has it been since you last visited a dentist or dental clinic for any reason? Include visits to dental specialists, such as orthodontists. (n=496) Percentage of adults obtaining preventative health care in the past 12 months Medical Dental In 28, the majority of Licking County residents reported seeing a physician for a check-up in the 12 months prior to the survey (75.5), significantly higher than 26 Licking County data. In addition, 69.9 of Licking County residents reported seeing a dentist within the past year, which is similar to the 26 data. Overall patterns were unchanged from the most recent Ohio data Licking 28 Licking 26 Ohio 1997 There were no statistically significant differences between genders for routine doctor or dentist visits Licking 28 Males Females Older respondents, especially those 65 and over, were significantly more likely to report having a routine physical exam within the past twelve months compared to those under 45. There were no statistically significant differences between age groups with regard to dental exams Licking and over

26 Licking County Health Department 28 BRFSS Page 26 Additional Subgroup Differences MEDICAL Checkups: Ethnicity: Education: Employment: Employed respondents were significantly less likely to have a physical exam within the past 12 months (66.1) compared to respondents with an employment status of Other (86.4). Household income: Additional Subgroup Differences DENTAL Checkups: Ethnicity: Education: As education levels increase, the percentage getting dental checkups in the past 12 months increase: o 47.1 of those with less than a high school degree had a dental checkup in this period. o 63.1 of those with a high school diploma or GED had a dental checkup in this period. o 73.8 of those with some college had a dental checkup in this period o 88.6 of college graduates and post graduates had a dental checkup in this period. This group was significantly more likely than all others to have obtained a dental checkup. Employment: Household income: Respondents with household incomes less than $25, were less likely to have obtained a dental checkup in the past 12 months (5). Respondents with household incomes of $5, - $75, and over $75, were more likely to have obtained a dental checkup in the past 12 months (78.2 and 87.8, respectively).

27 Licking County Health Department 28 BRFSS Page 27 Dental Health Cleaning Obtaining regular dental cleanings are another indicator of dental health. In Licking County, how many adults get their teeth cleaned regularly? How long has it been since you had your teeth cleaned by a dentist or dental hygienist? (n=456) Percentage of adults who had teeth cleaned in past 12 months In 28, 71.5 of Licking County respondents say they have had their teeth cleaned in the past year. This proportion is similar to the proportion reported in 26. In 28, only 2.2 of adults said they have never had their teeth cleaned Licking 28 Licking 26 No significant differences were noted between males and females No significant differences were noted among age groups. 1 8 Licking 28 Males Females Licking and over

28 Licking County Health Department 28 BRFSS Page 28 Additional Subgroup Differences: Ethnicity: White respondents were more likely to report having their teeth cleaned in the past year than non-white respondents (73.3 and 48.3, respectively) Education: Respondents with more education (a college degree) were more likely to report having their teeth cleaned in the past year (87.7). Respondents with less education (those with less than high school and a high school diploma) were less likely to report having their teeth cleaned in the past year (47.8 and 65.5, respectively). Employment: A larger proportion of employed respondents and those with an employment status of other (73.6 and 72.1, respectively) reported having their teeth cleaned in the past year compared to unemployed respondents (42.8). Household income: Respondents with household incomes greater than $75, were more likely to report having their teeth cleaned in the past year (88.6). Respondents with lower household incomes (less than $25, and between $25, and $5,) were less likely to report having their teeth cleaned in the past year (5.5 and 7.8, respectively).

29 Licking County Health Department 28 BRFSS Page 29 Dental Health Tooth Loss In addition to regular dental exams, tooth loss is another indicator of dental health. In Licking County, how many adults have had at least one tooth extracted? How many of your permanent teeth have been removed because of tooth decay or gum disease? Include teeth lost to infection, but do not include teeth lost for other reasons, such as injury or orthodontics. (n=497) In 28, 48.5 of Licking County respondents say they have lost at least one permanent tooth. This proportion is similar to the proportion reported in 26 as well as among all Ohio residents in 26 (49). In 28, of all adults who have lost any teeth, the majority (56.1) say they ve lost less than 5. Only 1 of all adults surveyed say they have had all their teeth removed Percentage of adults who have lost at least one permanent tooth Licking 28 Licking 26 Ohio There were no statistically significant differences between males and females with regard to tooth loss. Also, 8.6 of males and 11.2 of females say they have lost all their permanent teeth Licking 28 Males Females Older respondents (especially those 65 and over) were more likely to report they had had at least one permanent tooth extracted. Those over aged 65 were much more likely than all other groups to report they had all their permanent teeth removed (34.3 of this age group, compared to 4.8 of adults and less than 5 those 44 and under) Licking and over

30 Licking County Health Department 28 BRFSS Page 3 Additional Subgroup Differences: Ethnicity: Education: Respondents with less than a college degree reported more teeth lost than those with a college degree. Employment: Unemployed respondents and those with an employment status of Other reported more teeth lost than employed respondents. Household income: Respondents with higher household incomes (greater than $75,) reported fewer teeth lost than respondents with smaller incomes.

31 Licking County Health Department 28 BRFSS Page 31 Health Coverage Eye Care Questions regarding a particular form of health coverage eye care or vision insurance were also posed to those participating in the survey. Those with insurance to cover the cost of regular eye and vision checkups may be better positioned than others to preserve and protect vision. What percentage of adults in Licking County reported having health care coverage for eye care? Do you have any kind of health insurance coverage for eye care? (n=494) Percentage of adults with insurance coverage for eye care In 28, 63.5 of Licking County residents say they have health care insurance that covers eye care. This is statistically similar to the percentage reported in Licking 28 Licking 26 There were no significant differences in rates of eye care coverage between males and females Licking 28 Males Females Respondents age 65 and older were less likely than all other age categories to have health insurance coverage for eye care Licking and over

32 Licking County Health Department 28 BRFSS Page 32 Additional findings regarding health care coverage for eye care: Ethnicity: White respondents were more likely to have eye care coverage than non-white respondents (65.5 and 4.1, respectively). Education: Employment: Employed respondents were more likely to have eye care coverage (7.8). Unemployed respondents and respondents who had an other employment status were less likely to report having eye care coverage (43.4 and 56, respectively, had coverage). Household income: Those with higher household incomes ($5, - $75, and greater than $75,) were more likely to report have eye care coverage (73.6 and 75.7, respectively, had coverage).

33 Licking County Health Department 28 BRFSS Page 33 Eye Care Obtaining regular eye exams are important in order to preserve and protect vision. Among Licking County residents, how often do residents have their eyes examined? When was the last time you had your eyes examined by any doctor or eye care provider? (n=496) When was the last time you had an eye exam in which the pupils were dilated? This would have made you temporarily sensitive to bright light. (n=467) In 28, a majority of Licking County respondents have had their eyes examined, while about half had an eye exam where their pupils were dilated. This proportion is similar to the proportion reported in 26. In 28, only 1 of respondents said they had never had an eye exam and 12.1 said they had never had their pupils dilated Percentage of adults who have had an eye exam in the past 12 months Exam Licking 28 Licking 26 Pupils Dilated There were no statistically significant differences between males and females Licking 28 Males Females Older respondents (45 and above) were more likely to report they had a eye exam in the past 12 months than younger respondents (44 and below). Older respondents (45 and above) were also more likely to report having their pupils dilated during an eye exam than younger respondents Licking and over

34 Licking County Health Department 28 BRFSS Page 34 Additional Subgroup Differences- Eye Exam Within the Past Year and Exams in Which Pupils Were Dilated: Ethnicity: Education: Employment: Household income: ADDITIONAL FINDINGS REGARDING VISITS TO AN EYE CARE PROVIDER Participants who had not visited an eye care provider in the past year were asked what the main reason was that they had not done so. The most common reasons reported are listed below: REASON FOR NOT VISITING AN EYE CARE PROVIDER FREQUENCY No reason to go (no problem) 5.9 Cost/Insurance 26.1 Have not thought of it 7.9 Other 1.6

35 Licking County Health Department 28 BRFSS Page 35 Cataracts, Glaucoma, and Macular Degeneration To what extent have Licking County residents been diagnosed with medical issues that can have serious effects on one s eyes and vision, such as cataracts, glaucoma, or macular degeneration? Have you been told by an eye doctor or other health care professional that you now have cataracts? (n=499) you had glaucoma? (n=498) you had age-related macular degeneration? (n=498) As shown below, the percentage of survey respondents reporting any one of these eye issues in 28 is less than 8. Such low incidence levels make it difficult to provide meaningful subgroup differences (e.g., by male/female, age group) because the subgroup numbers are so small. Therefore, only comparisons to the 26 Licking BRFSS are made. In 28, the proportion of Licking County residents who now have cataracts (7.8) is significantly less than the proportion reported in 26. In 28, the proportion of Licking County residents who have ever had glaucoma (3.2) is statistically similar to 26 Licking County data and to 27 Ohio data Percentage of adults diagnosed with cataracts 15 8 Licking 28 Licking 26 Percentage of adults diagnosed with glaucoma Licking 28 Licking 26 Ohio 27 In 28, the proportion of Licking County residents who have ever been diagnosed with age-related macular degeneration (2) is statistically similar to 26 data. Percentage of adults diagnosed with macular degeneration Licking 28 Licking 26

36 Licking County Health Department 28 BRFSS Page 36 Visual Impairment Licking County residents were asked to indicate how well they could see, both close-up and at medium range (e.g., 1 feet away). If survey respondents usually wore glasses or contact lenses, they were asked to answer as if they were wearing them. Overall, the majority of Licking County residents interviewed reported they have no difficulty with their eyesight. How much difficulty, if any, do you have in recognizing a friend across the street? (n=499) No difficulty A little difficulty Moderate to extreme difficulty 85.5 How much difficulty, if any, do you have reading print in newspapers, magazines, recipes, menus, or numbers on the telephone? (n=499) No difficulty A little difficulty 77.1 Moderate to extreme difficulty

37 Licking County Health Department 28 BRFSS Page 37 Immunizations - Flu / Pneumonia Flu and pneumonia vaccinations are a critical component of preventative care, especially for adults aged 65 and over. How many older adults (those 65 and over) in Licking County have received these immunizations? A flu shot is an influenza vaccine injected into your arm. During the past 12 months, have you had a flu shot? (n=94) A pneumonia shot or pneumococcal vaccine is usually given only once or twice in a person s lifetime and is different from the flu shot. Have you ever had a pneumonia shot? (n=92) Percentage of adults (age 65+) who have had flu vaccination in past 12 months and/or pneumonia vaccination ever In 28, 79.7 of Licking County residents aged 65 and over reported having received a flu vaccination within the past year. Also, 8.5 of Licking County residents aged 65 and over reported having been vaccinated against pneumonia at some point in their lifetime. These results are slightly higher than rates reported for Ohio in Flu Pneumonia Licking 28 Ohio 27 There were no significant differences in vaccination rates by gender Licking 28 Males Females 3 Comparable data from Licking County s 26 BRFSS were unavailable.

38 Licking County Health Department 28 BRFSS Page 38 Additional Subgroup Differences FLU immunization: Ethnicity: Education: Employment: Household income: All respondents aged 65 and older and with household incomes greater than $75, reported getting a flu shot in the past 12 months. Additional Subgroup Differences PNEUMONIA immunization: Ethnicity: Education: Employment: Household income: All respondents aged 65 and older and with household incomes greater than $75, reported getting a pneumonia vaccine.

39 Licking County Health Department 28 BRFSS Page 39 Colon Cancer Screening All adults over the age of 5 should be checked for colon cancer. To screen for colon cancer, people could have a sigmoidoscopy or colonoscopy or could use a home kit to determine whether their stool contains blood. Such tests should be repeated every 5 1 years. How many adults in Licking County have had these screening procedures? Sigmoidoscopy and colonoscopy are exams in which a tube is inserted in the rectum to view the colon for signs of cancer or other health problems. Have you ever had either of these exams? (n=224) A blood stool test is a test that may use a special kit at home to determine whether the stool contains blood. Have you ever had this test using a home kit? (n=224) Percentage of adults (age 5+) who have had colon cancer screenings In 28, 58.9 of all adults aged 5 and over say they have received at least one sigmoidoscopy or colonoscopy in their lifetime. This proportion is similar to 26 Ohio data and 26 Licking data say they have used a blood stool kit at home. Among these adults, 82.9 have had a colonoscopy and 85.7 have had a blood stool test in the past 5 years Sigmoidoscopy or Colonoscopy Blood Stool Test Licking 28 Licking 26 Ohio 26 There were no significant differences between males and females for these procedures There were no significant differences between respondents who were 5 64 compared to those 65 and over for these procedures Licking 28 Males Females Licking and over

40 Licking County Health Department 28 BRFSS Page 4 Additional Subgroup Differences - Sigmoidoscopy or Colonoscopy : Ethnicity: Education: College graduates were more likely to report having received a sigmoidoscopy or colonoscopy (8.4). Those with a high school education or some college were less likely to report having received one of these procedures (57.4 and 53.7, respectively). Employment: Household income: Respondents with household incomes greater than $75, were more likely to have received one of these procedures (79.7) than respondents with household incomes less than $25, (43.8). Additional Subgroup Differences Blood Stool Test: Ethnicity: Education: Employment: Household income:

41 Licking County Health Department 28 BRFSS Page 41 Prostate Cancer Screening According to Ohio s 27 BRFSS, 3 of men over the age of 4 have been diagnosed with prostate cancer. What preventative measures are men in Licking County taking to ensure successful detection and treatment of this disease? There are at least two ways men can be tested for prostate cancer: by receiving a digital rectal exam from their healthcare professional or by having a blood test called a Prostate-Specific Antigen (or PSA) test. How long has it been since your last PSA test? (n=15) How long has it been since your last digital rectal exam? (n=153) Percentage of men (age 4+) who have had a prostate cancer screen in past 2 years In 28, 58.8 of all Licking County men aged 4 and over say they have received a PSA test within the past two years. This proportion is similar to the Licking County and Ohio data from 26. In addition, 5.9 of men over 4 reported having a digital rectal exam within the past two years, a rate similar to 26. State data for digital rectal exams are unavailable PSA Digital rectal Licking 28 Licking 26 Ohio 26 There were no significant differences between men 4 64 and 65 and over for either type of prostate screening. Additional Subgroup Differences: Ethnicity: No statistically significant differences were noted. Education: No statistically significant differences were noted Licking and over Employment: Household income: